Navigators Barred From County Health Departments

Published September 11th, 2013

MIAMI (AP) - Counselors trained to help sign people up for health insurance under the Affordable Care Act won't be allowed to conduct their work at county health departments across the state, according to a recent directive from the Florida Department of Health.

Local health departments can accept brochures and other outreach material about insurance under the new state exchange, but the materials will apparently only be distributed if someone asks for it. Agency officials said they sent a memo earlier this week to provide clarity for local departments around the state about the counselors, also called navigators, because the navigators aren't acting on behalf of the state. The directive comes just weeks before the Oct. 1 launch date to start enrolling in the state exchange and political hype is ramping up on both sides of the aisle about the controversial health law.

"This program has raised privacy concerns due to the consumer information that will be gathered for use in a federal database. In light of this uncertainty and as an integrated Department of Health we sought to provide a consistent message across each county in Florida," the agency said in a statement Wednesday.

Gov. Rick Scott and Attorney General Pam Bondi have expressed similar concerns about privacy recently, joining other Republicans around the country who have been critical of so-called "Obamacare." Bondi is among attorneys general in 13 states who sent a letter to Sebelius last month questioning whether there will be enough protection of consumer data in the Navigator program, saying the agency's current guidelines "suffer numerous deficiencies."

Scott also said there are many serious, unanswered questions about the navigators and ordered his cabinet to address the issue at a meeting last month, although nothing was resolved.

The federal government gave several Florida organizations nearly $8 million in grants to hire navigators to assist with the state exchange. Navigators will help people with various aspects of choosing an insurance plan under the new state exchange. For example, they might help someone estimate their family income for 2014, important in determining eligibility for federal tax credits to help pay the cost of coverage. As such, an applicant will have to furnish a Social Security number, tax documents and immigration status to determine eligibility for benefits.

Federal health officials said applicant information is not stored in a database, but is instead transferred instantaneously through a secure hub. For example, IRS officials won't have access to health information or information about an applicant's immigration status.

Navigators will be especially important in Florida where the Republican-controlled legislature has been resistant to the Affordable Care Act and opted to let federal officials run its state exchange, an online site where individuals and small businesses can shop for health insurance. The state isn't spending any additional money on outreach efforts to get the message out to roughly 3.5 million uninsured Floridians.

Under the new online exchange, consumers will be able to choose from bronze, silver, gold, platinum and catastrophic plans that offer a range of premiums, deductibles and co-pays depending on variables such as how many doctors you want included in your network. Insurers are offering 308 plans through the exchange in Florida, according to state insurance officials.

Individuals will have to have health insurance from their employer or purchase it, and will pay a roughly $100 penalty next year if they don't. Anyone making below the poverty line won't be eligible for subsidies through the online marketplace. Federal health officials anticipate roughly 1 million Floridians will fall into a gap where they can't get health insurance because the state rejected Medicaid expansion.